Active NPI
David J Maharty, D.M.D
- Dentist
- Williamsburg, VA
National Provider Identifier
1417976259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401413155
- Practice address
- 1131 Professional Dr
Williamsburg, VA 23185-3329 - Phone
- (757) 220-0330
- NPI assigned
- Jul 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS029416-L | PA | |
| Dentist | 122300000X | 0401413155 | VA | Primary |
Addresses
Primary practice location
1131 Professional Dr
Williamsburg, VA 23185-3329
Mailing address
1131 Professional Dr
Williamsburg, VA 23185-3329
Phone (757) 220-0330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 15, 2015 through Sep 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401413155 | VA | MD | Dentist |
| DS029416-L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456444800000",
"number": "1417976259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1131 PROFESSIONAL DR",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231853329",
"telephone_number": "757-220-0330"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1131 PROFESSIONAL DR",
"city": "WILLIAMSBURG",
"state": "VA",
"postal_code": "231853329",
"telephone_number": "757-220-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHARTY",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-19",
"last_updated": "2016-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS029416-L",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401413155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.